| NPI | 1114577343 |
|---|---|
| Doing Business As | GREENHAVEN MODERN DENTISTRY DENTAL |
| Entity Type | Organization |
| Authorized Contact | AHMAD MOKBIL Owner 916-221-9970 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2019-09-19 |
| Last Update Date | 2019-09-19 |